1.8 Are CAR-Ts stuck?

When they first emerged, chimeric antigen receptor T-cell (CAR-T) therapies seemed like the stuff of science fiction. The basic idea of reprogramming T-cells is decades old. It involves isolating a patient’s T-cells, genetically modifying them to express a new receptor that recognizes a target protein, such as an antigen expressed by a cancer cell, and putting them back into the body, where they can expand and attack cancer cells. 

In early clinical trials, they had dramatic, curative effects for some patients. In others, however, they over-stimulated the immune system and unleashed fatal cytokine storms. The field has learned how to manage these toxicities. Novartis secured the first CAR-T approval in 2017 with Kymriah (tisagenlecleucel) for treating acute lymphoblastic leukemia. It gained subsequent approvals in two other forms of blood cancer, B-cell lymphoma and follicular lymphoma. All of them express the CD19 receptor, which Kymriah is designed to recognise and attack. But progress since Kymriah’s emergence has been slow. Just five other CAR-T therapies have been approved since then, and three of them target CD-19. The other two are approved for treating another type of blood cancer, multiple myeloma, by targeting B-cell maturation antigen. 

Despite enormous efforts, however, developers have been unable to develop successful CAR-T therapies for solid tumors. Is the field stuck? Are alternative approaches more effective? And can the concept be applied to other types of immune cells and other types of disease?

Suggestion box (Suggestions on future episodes, points for clarification, comments, etc.)

Subscribe (Get notified when new episodes are available. NO marketing!)

Follow us on LinkedIn

Disclaimer